Board Exam Primer from topnotch

TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected]

Primer to The Philippine Physician Licensure Examinations by Enrico Paolo Chiong Banzuela, MD and Vincent Maranan Varilla, MD Outline I.

II.

Basic Information About Philippine Physician Licensure Examination A. Introduction to the Med Boards B. Registration for the Med Boards C. The Realities of the Med Boards D. Annual Passing Rate of Med Graduates in the Med Boards E. The Process of Making Board Exam Questions F. The Process of Grading the Board Exams Preparing for the Med Boards A. Preparing for the Med Boards During Med School B. Preparing for the Med Boards During Internship C. Preparing for the Med Boards After Internship D. Preparing for the Med Boards on the Actual Day E. Preparing for the Results of the Med Boards

III.

Personal Recommendations A. Books to Read B. Suggested Routine Schedule C. Maintaining Proper Attitude and Focus

IV.

Frequently-Asked Questions

V.

Final Advice

If you are going to take the Med Boards during August, request for the last three documents as early as possible—as early as May from some Med schools—from your school since they take some time to process. Aside from these documents, you also need the following: • Four (4) 2x2 full-face photographs with name tag (Last Name, First Name and Middle Name—known to many photo developing shops) • Postage stamps bought from INSIDE the PRC compound • One (1) government-issued ID • One long brown envelope • Pencils(Mongol #2) • Erasers, black ball pen and paste. For the updated complete steps in registration (with accompanying pictures), visit www.topnotchboardprep.com.ph. C. The Realities of the Boards What do you think is the best way to prepare for the board exams? According to studies done so far both on the USMLE and on the Philippine Med Boards, the answer is simple. The best way to prepare for the Med Boards is to study well during med school. This answer is very basic, and very fair. If you’ve studied hard and received good grades in med school, you are more likely to pass the med boards compared to someone who didn’t work as hard and received poor grades. But then again, the word “likely” is not the same as the word “certain.” There will be exceptions –people who overachieve or underachieve during the taking of their med boards. So we suggest that you read this whole primer with gusto, think critically and start planning for you own med boards. Afterwards, carry out that plan with discipline , unwavering drive, and steadfast motivation. Just a few things we would like to point out about the Med Boards: 1.

Most of you will never feel 100% prepared. You may study for 3 months or 6 months, read thru many review books twice or thrice, answer sample exams for weeks, but in the end, there would always be the feeling that you still don’t know enough -kulang pa. Don’t be too hard on yourself. As long as you have a well-written plan and you have carried out that plan to the best of your abilities, have faith in yourself and have faith in God.

2.

Most of you will feel that you have flunked. Whether it’s the entire Med Boards, or just one or a few subjects, most of you will feel that you have flunked the Boards right after taking the exam. Understand that this is a natural reaction due to the difficulty of the exams, and take comfort in the fact that your colleagues must be feeling the exact, same thing. Hope for the best and pray.

3.

The Boards is an imperfect exam. There will be some typos, grammatical errors, and repeated questions in the board exams. Expect these and do not be distracted by them too much. Of late, the Board of Medicine seems to be more and more serious about the quality of the exams, so these imperfections occur less and less frequently. But when they do occur, expect them and don’t get thrown off too much. Move on to the next question.

4.

Rumors distract you from the goal. There will be plenty of rumors before, during and after the exams regarding exam “leakages”, list of passers even before the actual announcement by the PRC, ‘patok’ resources that should have been read because questions were lifted from them ‘word for word’, etc. We suggest that you ignore them. That’s right: ignore them. In almost every case these rumors are untrue and unfounded, and they serve as a distraction. Focus on the exam before and during Med Boards. Pray and hope for the best after.

I. BASIC INFORMATION ABOUT THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS A. Introduction to the Med Boards The Philippines Physician Licensure Examination (the “Med Boards”) is given twice a year (February and August) usually during 2 consecutive weekends (Saturday and Sunday during the August Boards, Sunday and Monday during the February Boards) in 3 sites – Manila, Cebu and Davao. Every medical graduate who has finished his internship in the Philippines needs to pass the Med Boards in order to obtain his medical license and practice medicine in the country. A medical graduate needs to pass the med boards only once in order to obtain his license. He or she must pass the Med Boards within his first three attempts; otherwise, he would have to take a 1-year refresher course given only by certain med schools. Currently, there is no limit to the number of times a medical graduate may attempt taking the Boards. The Med Boards can be informally classified into 6 Basic Sciences subjects (Anatomy, Physiology, Biochemistry, Microbiology, Pathology and Pharmacology) and 6 Clinical Sciences subjects (Internal Medicine, Obstetrics & Gynecology, Pediatrics, Surgery, Legal Medicine and Preventive Medicine). Three subjects are tested during each exam day. There are 100 multiple choice questions for each subject. This 2010, the Med Boards is scheduled on August 7,8, 14 and 15. A typical Schedule of the 4 days of the Med Boards is as follows: Day 1 2 3 4

8am-10am Biochemistry Physiology Pharmacology Ob-Gyne

11am-1pm Anatomy Legal Med Surgery Pediatrics

2pm-4pm Microbiology Pathology Internal Med PrevMedicine

B. Registration for the Med Boards To take the exam, you must personally register at the Professional Regulatory Commission, located at P. Paredes St., corner Morayta St. Sampaloc, Manila. This is near the area between the University of Santo Tomas and Quiapo. You will know that you’re in the right place when you start seeing numerous review centers as well as vendors selling medical DVDs and books. You need the following documents in order to register for the Boards (one original and one photocopy): • NSO-certified Birth Certificate • Certificate of Graduation • Certificate of Internship • Medical Transcript of Records

Here is general feedback by medical graduates about the last two Medical Boards (August 2009 and February 2010). They have said that, as a whole the Boards: 1.

Had “jumping” questions present, meaning there were Pathology questions found in the Physiology exam, and Pharmacology questions in the Biochemistry. We interpret this development both as an attempt by the Boards to be integrative, and as a challenge to the student to become more critical.

2.

Began asking two-step questions. For instance, you will be presented with a case featuring the signs and symptoms of a disease. Without naming the disease in the question stem, you

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] may be asked for the microscopic findings classically seen in that disease. You must therefore be able to diagnose the patient, and then be able to identify the microscopic findings typical of that disease. We interpret this as an increase in the sophistication and intelligence behind the Board questions being made. This is certainly advantageous as it requires more analytical thinking, but it does assume that you have many facts memorized. 3.

Medical graduates tend to focus their study on Biochemistry and Anatomy, since these are the subjects that they fear the most even while they were in Med School. However, if the student’s actual performance in the Boards is indicative of the difficulty of the subjects, then these subjects are actually not the hardest. Certainly they do not deserve the fear that they inspire in most students. Students, surprisingly, usually receive their lowest scores in Surgery. The difficulty of the exams have somewhat shifted, as lately, graduates are also now beginning to experience more difficulty with the clinical sciences subjects compared to the basic sciences subjects. Most especially during the last two board exams, Prev Med(!) and Surgery have emerged to become the most difficult subjects, with Prev Med no longer the source of relatively easy high marks.

4.

Although recall questions are still being asked, (especially for Biochemistry) the number of comprehension and analysis questions is increasing, which again points to more sophistication and more skill in test-making by the Board of Medicine.

5.

Each subject may become easier or harder since it appears that the members of the Board of Medicine are rotating the subjects among them, or at the very least are using different sources with period of exams. Biochemistry for example was relatively easy, recall-type during the last two years except for the last Med Boards. That’s why comprehension of the entire subject (and not just particular, favorite topics—which apparently was the norm during the last exams) is important. The Board of Medicine seems to be communicating—via the Med Boards—that you should study to become good, caring and competent doctors. Don’t study merely to pass a test. Here is the summary of our findings on a per-subject basis:

Biochemistry Biochemistry is a subject feared by many medical graduates about to take the boards, but again (see above) it is not as difficult a subject if compared against actual performance, and in comparison to performance in other subjects. With a good understanding of its core principles, it is very likely that you can really get a good score in this subject. Usually, rate-limiting enzymes, specific characteristics of amino acids, and diseases with biochemical bases were commonly asked. In the last board exams, the questions have also become a little more difficult, with less questions on pathways. Nonetheless, it appears that it is still not the subject most commonly failed by students who don’t pass the Boards. Example of Typical Questions – Disease associated with Cherry-Red Spot (Tay-Sachs), nutritional deficiency associated with night blindness (Vitamin A deficiency), Application of Chargaff’s rules. Anatomy The most common mistake of medical graduates with regards to studying Anatomy for the Med Boards is to focus their study on specific systems that they’ve gathered were heavily tested during the previous Board Exams– e.g. Musculoskeletal System for the boards of two years ago, or the Female Reproductive System for the previous two Boards. It is very easy to fall in the trap of limiting study to these ‘high-yield’ systems. What we’ve noticed, however, from anecdotes of test-takers is that during the past 3 years, a few specific systems do receive greater emphasis over others, but the choice of these systems is changed with every exam. For instance, for the coming Anatomy exams, they might ask plenty of questions for Chest and Abdomen, but for the next med boards, more questions may be asked in the Musculoskeletal system. The selection of these emphasized systems, we’ve discovered, cannot be predicted with any great degree of accuracy. That’s why it is important to get a good understanding of all systems and not to focus on particular body regions. Histology questions used to be rare in the board exams (usually less than 10 questions) but in the last Med Boards, there was quite a number of questions that appeared (although reports indicate that the questions were not as hard as your histology questions during med school). Once again, for Anatomy, study all systems including histology with equal attention. Don’t play favorites with this subject! =) Clinical correlations are increasing in anatomy exam. So be guided by the cases in Snell and Moore during your review. Lastly, don’t forget to use Netter’s Atlas for your review. If you have not used Netter to study before, this is a good time to start. We highly recommend this because it works, and it really, really, helps.

Examples of Typical Questions: Spinal Nerves affected in ErbDuchenne palsy (C5-C6), Organs appreciated in the rectal exam, type of epithelium in the upper part of the esophagus. Microbiology Microbiology is sometimes easy, but sometimes it can be quite hard, too. What we are actually saying is that oftentimes, its difficulty is unpredictable. Some questions can be extremely easy and common sense. For instance, an extremely easy question can start with: “The following are bacteria, except…” Sometimes, however, microbiology is so hard that you will really fear for your grade. For the most part, questions about bacteria remain the main focus of the exam, followed by viruses, then fungi. Parasitology questions are also asked, usually 5-15 questions in the exam. Medical graduates basically read the same thing for microbio, so mastery of your readings will be the determining factor. Microbiology questions are mostly recall in nature, with a few application questions thrown in. Don’t forget to study parasitology but don’t spend more time in it than micro. Use your parasitology notes during med school, or get the Philippine Textbook of Parasitology written by Dr.Belizario. Be aware of “jumping questions” in microbiology – you’ll likely see pharmacology questions and pathology questions in this subject quite often. Be aware as well that a good time to study your anti-microbials is with Micro, as this is a good integration of two key Board subjects. Examples of Typical Questions: Bacteria associated with Swarming motility (Proteus), PPD Test, Malaria Cycle. Physiology The worst thing that you can do with physio is to memorize it without comprehending it. Recall questions are rare in this subject – mostly comprehension, application and analysis type of questions are asked, and most of them are in the clinical setting. Therefore you need the ability to explain, expound and extrapolate. This is where smallgroup discussions would really help. Creating diagrams and concept maps are also useful. Examples of Typical Questions: Eyeball changes in myopia, hyperopia, Sympathetic vs Parasympathetic actions, renin-angiotensinaldosterone system (RAAS). Legal Medicine If there is one subject that you might be able to score extremely high in, it’s Legal Med and Juris. All questions are based on the two immortal Solis Books, and few laws have changed since their writing. That’s why if you’ve read these two books during med school, you likely won’t have any problems with this subject. Also, since these two textbooks have been the only basis of all questions for this subject for the past twenty or so years, many possible questions have already been asked. Usually, they will just tweak some of the information in the question stem, but the basic principle would still be asked. Answering and analyzing sample exams in this subject is definitely helpful – you won’t get the exact questions and answers, but since the basic principles are still there, you’ll be able to eliminate a lot of wrong choices in the actual exam which will lead to a higher grade. Sample exams from UERM, Fatima are particularly helpful. These were written by their consultants years ago, as a contribution to the existing pool of knowledge and to help students comprehend Legal Med better. Get compiled versions of these questions from your friends who graduated from these schools. Examples of Typical Questions: cases involving “Res Ipsa Loquitur”, elements of qualified seduction, definition of demi-virgin. Pathology The trend of less recall questions being asked and more 2-step questions and analysis questions being given is particularly evident in this subject. That’s why right now, aside from knowing particular “buzzwords” associated with a disease (e.g. Ghon’s Focus in TB), you must know what that particular buzzword means. You need to study pathology very well because if you do, you’ll also have a higher chance of passing other integrative subjects like Internal Medicine, Pediatrics, Physio, Pharma and even Micro. Examples of Typical Questions: Feature of Hodgkin’s Lymphoma (Owl’s Eye), 45 XO (Turner’s Syndrome), characteristics of Rheumatic Heart Disease, Multiple myeloma Pharmacology This subject still has plenty of recall questions, meaning if you just manage to cram particular info in your memory, you will get a good grade in this subject. Questions typically revolve around indications, contraindications, mechanism of actions and adverse effects of drugs. Adverse effects seem to be a favorite in the exams. Create tables and diagrams of drugs using the info above and review them repeatedly so you’ll be able to memorize them. Also, we highly recommend that you create your very own drug list, in a way that is easiest for you to memorize. Understand the basic MOA of each class of drug, then memorize the drugs under each class.

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] Examples of Typical Questions: Folic Acid Antagonists, indication of anti-arrhythmic drugs, adverse effect of TB drugs, adverse effect of chemotherapeutic drugs.

Examples of Typical Questions: sensitivity vs specificity, immunization schedule, rat-proofing your house, case-control vs cohort studies

Surgery

D. Annual Passing Rate of Med Graduates in the Med Boards

Usually, the lowest score in the Med Boards of most medical graduates is in Surgery. And the questions here are indeed hard! We think even surgery resident doctors will find the questions challenging. Procedures, treatment of choice, anatomic correlations are asked. Your experiences during your surgery rotation would really help in this subject. To compensate for your score in surgery, you should have a very high score in legal med and other subjects. Spend a reasonable amount of time reviewing for surgery but don’t overdo it to the point that your score in the other subjects will be affected. Chances are, even if you study really well for this subject, it would boil down to you eliminating wrong choices per question rather than knowing the correct answer. So sharpen your testmanship skills, frequently answer sample exams in order to know both the scope of subject material being asked and understand how to answer Surgery questions, do you best, and pray. Examples of Typical Questions: Billroth I and II, Burns, Pediatric Surgery Internal Medicine If you have studied well in Physiology, Pathology, Microbiology and Pathology, you won’t have any problems with this subject. It will no longer be that hard, but it won’t be that easy also. So the message is clear: study Internal Medicine on its own, and don’t ‘sacrifice’ this subject in favor of others. Read Internal Medicine again, and you will see many overlaps with your previously studied basic sciences—this will serve as excellent second or third reading. Questions here are quite fair and if you’ve managed to read Harrison’s, you’ll be able to answer almost all questions. But even if you haven’t, as long as you’ve mastered the four basic sciences mentioned above, you have a good chance in getting a good score in this subject. Questions may sometimes be tricky, especially with regards to diagnosis, but you will be able to eliminate wrong choices. You experience once again during clerkship and internship would help. Examples of Typical Questions: Differences between Type 1 and Type 2 DM, R-sided vs L-sided Heart Failure, COPD Ob-Gyne This subject is getting harder and harder, and if anecdotes by previous Board takers prove true, is increasingly becoming the source of many failed marks by students. It’s slowly becoming another subject similar to Surgery. Diagnosis and treatment are the main focus. There will be plenty of clinical cases. Sample exams will help, not in giving the exact questions and answers, but in preparing you to answer clinical cases using the MCQ format. Again, your experience during your Ob-Gyne rotation in clerkship and internship would help. Most graduates will feel that OBGYN was taught well in their institutions, but do not fall into the trap of thinking that you can rely on experience alone. You really need to devote some time to read your review books for OB. There are more questions in obstetrics than gynecology, but expect gyne-onco questions and some questions about STDs. Examples of Typical Questions: DUB, placenta previa, eclampsia

Pediatrics Similar to Internal Medicine – your knowledge in Physiology, Pathology, Microbiology and Pathology would help. So would your experiences during your clinical rotation. There are plenty of questions dealing with clinical cases in this subject. Once again, in terms of difficulty, it’s not as easy as, say Legal Med, but not as hard as Surgery or Prev Med. Historically, however, Pediatrics was once one of the most feared subjects because the questions could be anywhere in Nelson’s large book of tiny text. Lately, however, questions have become more manageable, and it is no longer the extremely difficult subject it used to be. However, it remains challenging and is definitely worth studying hard for. Examples of Typical Questions: differences between breast milk and cow’s milk, lumbar tap findings of specific types of meningitis, features of Kawasaki’s disease. Prev Med Once upon a time (not too long ago actually), this was the easiest subject in the Med Boards, used by many graduates to pull up their average. But not for the last 1 ½ years. If you ask previous Board takers, they may claim that this subject can feature many “out-of-thisworld” questions. “Out of this world” because most students did not study these topics as part of Prev Med. Epidemiology questions are also increasing. Study as hard as you can for this subject and use other subjects to compensate for your score here.

Here is the national passing rate for the Philippine Physician Licensure Examinations according to PRC: Year 2004

2005

2006

2007

2008

2009

2010

Date of Exam Feb Aug Total Feb Aug Total Feb Aug Total Feb Aug Total Feb Aug Total Feb Aug Total Feb Aug Total

No. of Passers 948 1,183 2,131 1,084 1,471 2,555 1,101 1,491 2,592 1,192 1,737 2,929 1,054 1,513 2,567 1,087 1,680 2,767 621 ??? ???

No. of Examinees 1,825 2,301 4,126 1,990 2,864 4,854 2,028 2,696 4,724 2,223 2,656 4879 1,985 2,506 4,491 1,685 2,357 4,042 1,344 ??? ???

Passing Rate 51.95% 51.41% 51.65% 54.47% 51.36% 52.64% 49.86% 55.30% 54.87% 53.52% 65.40% 60.03% 53.10% 60.38% 57.16% 64.51% 71.28 68.46% 46.21 ??? ???

The average annual passing rate for the past 5 years is 57.35% – better than the Bar Examinations (for lawyers), accountancy boards and nursing boards. This means that your chances of passing the boards are greater than 50%. The odds are therefore stacked in your favor and that is definitely good news. However, take note that the results of the last board exams (Feb 2010) of 46.21% was the lowest in recent memory (we have the passing rates from 1992-2010 and this is the lowest ever in that range). Three board exams before the Feb 2010 Med Boards, the passing rate averaged 65.39% - a difference of 19.18%. Take this as a challenge and a way to motivate you further to pass the Med Boards. After all, statistics can only describe what happened after – the passing rate maybe just 10%, but as long as you’re part of that magic 10%, it’s ok. For those who are curious to know, the PRC has released the passing rate of students according to Med School. Keep in mind that the passing rate of each Med School in the Med Boards may be dependent on several factors – their admissions policies, their curriculum, grading, etc. If you’re interested, just Google it. E. The Process of Making Board Exam Questions The Board of Medicine is composed of 5-6 doctors not affiliated with any medical school who are appointed by the President of the Philippines to create all 1200 questions for the Boards. The members of the Board of Medicine divide the 12 subjects among themselves and submit thousands of questions to a computer which randomly chooses the questions for the Boards. As of May 2010, the current members of the Board of Medicine include the following: 1. Dr.Mildred Pareja – Chairman 2. Dr.Jose Cueto 3. Dr.Edgardo Fernando 4. Dr.Florentino Doble 5. Dr.Miguel Noche 6. Dr.Restituto de Ocampo The following measures were instituted to prevent cheating and leakages in the board exams: 1. Exam questions are printed on the day of the exam. 2. Members of the Board of Medicine are confined inside the PRC Building during the duration of the Boards. 3. Answer sheets are identified only by numeric codes, not by the names of the examinees. Only the computer has the master list of codes matching with names if the examinees. 4. Any unnecessary marks on the answer sheet will invalidate the examinee’s score. There is a practice by some medical graduates that we do not find useful: researching the specialties of the members of the Board of Medicine to anticipate the kind of questions that will be asked. The Board of Medicine is composed of many esteemed doctors, and the questions

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] they can ask vary and can be changed by them as they see fit, so it is futile to try to predict the exact questions that will be asked. Also, we believe that the 3-6 month review for the boards should serve as way to increase your medical knowledge with the goal of becoming a competent physician. We don’t think you can do this properly if you’ll be focusing on particular topics or particular systems due to the specialty of the examiners, his style of questioning, etc. Moreover, we also believe that this practice simply does not work. At least two of the current members of the Board of Medicine took up their Master’s in Health Professions Education at UP-NTTC, and were adequately trained to give proper and valid questions that will test your competence and medical knowledge, rather than your testmanship skills. The other members also underwent training in order to create proper, valid questions. While the questions that they give are not perfect, it is clear to many med graduates now that these questions are certainly constructed better than before. Are there any specific books where the Board of Medicine bases their questions on? The PRC actually releases a guide containing suggested books (read: textbooks!) to read for exams. Based on our experience and those who have taken the exams before us, the examiners get their questions from the following: 1. Textbooks 2. Review books 3. Clinical experience 4. The planet Mars (some examinees remarked that the questions are “out of this world!” =) Of course, we are, indeed, joking. All questions were formulated by your Board of Medicine, and they do not come from Mars. But some students swear that they do ☺) Be careful when someone who has previously taken the Med Boards tell you the following phrases: “Patok to!”, “Kinuha yan sa libro na ito word-for-word” “Galing ang mga tanong sa samplex na ito.” Based on experience: 1.

Most of med graduates’ “word-for-word” experiences are false, or at the most, misinterpretations. They see a particular word in the Med Board question (e.g. Aldosterone) and then they see the same word in one of their sample exams or review books and they think that the exact question (including question phrasing and choices) was asked. They were recognizing topics, and they mistook this for recognizing whole questions. This “word-for-word” phenomenon is particularly evident on subjects which ask a lot of recall questions (e.g. Biochemistry) or are based on a particular textbook year after year. (e.g. Legal Med and Juris) It certainly makes for good gossip, but that’s just about it.

2.

While a very small percentage of the total number of questions may have been lifted directly from textbooks/review books/sample exams in previous exams, it doesn’t necessarily mean it that it is bound to happen again. In fact, it’s highly probable that it won’t. One review book maybe the basis for “patok” questions right now, but how about the next Med Boards? People who choose their review books/sample exams based on what people claim to be the source of “word-forword” questions are basically not studying for their upcoming board exams. They are studying for the previous board exams! And that is certainly not a good and logical move, right?

In the Med Boards, pa-streetsmart doesn’t work. Create a good plan, and review well. Review with every intention to cover everything that a good general practitioner would need to know in order to practice medicine competently. F. The Process of Grading the Board Exams To pass the Boards, your average grade on the 12 subjects must be 75% with no grade lower than 50% on any of the subjects. A grade of 75% on one subject doesn’t mean you only had 25 mistakes out of 100. The mean passing level (MPL) of the entire batch of examinees is obtained per subject using what we call the Nedelsky Method. Your raw scores are then transmuted based on the MPL. Because of the MPL, the passing rate may change depending on how easy or difficult the exam is. Usually, the MPL is less than a raw score of 75. This means that you would probably still pass if you answer 50-60% of the questions right. Let us give you a short overview on how they compute for the MPL using the Nedelsky method. After all the members of the Board of Medicine have given their questions, each of them will compute for the MPL of each subject using the Nedelsky method. In the Nedelsky method, you have to evaluate each question and each choice while assuming the mentality of a borderline student. (a student whose level of competence is “just enough” to pass the exam)

For example, we have this question: Q1: What is the name of the actress who last played the role of Darna? A. Marianne Rivera B. Nanette Medved C. Judy Ann Santos D. Angel Locsin If we were to grade this question, we think the borderline student must be able to rule out Judy Ann Santos as a possible answer. (it’s quite well-known that she actually played the role of Kristala and not Darna). The MPL for this question would be the reciprocal of the remaining choices. Since out of the 4 questions, we’ve easily ruled out one and left with 3, the MPL for this question would be the reciprocal of 3 or 1/3 or 0.33. Let’s have another example, and a more serious one: Q2: What is the mechanism of action of Cimetidine? A. It reduces pepsin formation at Histamine-1 (H1) receptors B. It blocks histamine stimulation of gastric acid secretion by the receptors C. It strengthens the protective coating in the intestinal wall D. it increases the bicarbonate ion secretion, neutralizing the pH Once again, if we were to grade this question, we think the borderline student would be able to rule out choices C and D as wrong. We think he’ll be competent enough to know that Cimetidine is somehow associated with histamine. We would then be left with 2 choices. The reciprocal of this is ½ or 0.5. Therefore my MPL for this question is 0.5 Since there are 100 questions per subject, add the MPL for each question to get the total MPL for the subject. To minimize examiner subjectivity, the average MPL of all 6 Board of Medicine Members will be the final MPL for that subject. This final subject MPL will then be the passing mark for that subject. If it’s 55, it means you need to get a raw score of 55 to pass the subject. If it’s 85, you need to get a raw score of 85 to pass the subject. They would use a transmutation formula to compute for the score that they would report to you. So once you get your grades at the end of the Med Boards, please note that those are not your raw scores, but transmuted scores based on the MPL. You need to get a transmuted score more than 50 per subject, and an average transmuted score of 75 to pass the Med Boards. II. PREPARING FOR THE MED BOARDS A. Preparing for the Boards – During Med School The best way to prepare for the Med Boards is to study well and get good grades during med school. Med school performance is a proven determinant of Board Exam performance. Therefore, please read your textbooks during med school. Don’t rely too much on transcriptions and sample exams. If you want to top the board exams, using textbooks instead of review books would really help a lot. What are the textbooks that the PRC recommends that we actually use for the Med Boards? Biochemistry 1. Harper’s Biochemistry (Murray, Granner, Mayes and Rodwell) 2. Biochemistry (Mckee and Mckee) 3. Biochemistry (Mathews and VanHolde) Anatomy and Histology 1. Clemente, C.D. Edition; Anatomy, A. Regional Atlas of the Human Body, 4th Edition, Williams and Wilkins, Philadelphia 1977. 2. Snell, R.S.; Clinical Anatomy for Medical Students, 5th Edition, Little Brown and Company, Boston 1995 3. Cormack, D.H.L. Clinical Integrated Histology, Lippincott-Raven, Philadelphia 1977. Microbiology and Parasitology 1. Zinzzer Microbiology, Current Edition 2. Beaver Clinical Parasitology, current Edition 3. Jawetz Medical Microbiology, current Edition Physiology 1. Textbook of Medical Physiology by Guyton Lamb, Ingram Johnson and Pitman: 2. Essentials of Physiology 3. Review of Medical Physiology by William F. Ganong 4. Human Physiology and Mechanism of Disease by Arthur C. Guyton and John E. Hall

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] Legal Medicine 1. Legal Medicine by Pedro Solis, MD, LlB. 2. Medical Jurisprudence (The Practice of Medicine and the Law) by Pedro Solis, MD, LlB. Pathology 1. Cotran, R.S., Kumar, V. & Collins, T: Robbins Pathologic Basis of Disease; 6th Edition; W.B. Saunders Company, Philadelphia 1999. 2. Danjanor, I. And Linden, J.: Anderson’s Pathology, 10th Edition, Volume 1 and 2, Mosby, Boston 1996. Pharmacology 1. Goodman & Gilman’s the Pharmacological Basis of Therapeutics, Ninth Edition 2. Basic and Clinical Pharmacology by Bertram G. Katzung, MD, PhD. Surgery 1. Basic Surgery (Poll, Gardnesr and Stone) 2. Textbook of Surgery (Sabiston) 3. Textbook of Surgery (Schwartz) 4. Ophthalmology, Principles and Concepts (Dewell) 5. Ophthalmology,, Secrets (Vander and Gault) 6. Fundamental of Otorlaryngology (Adams, Boies and Hilger) Internal Medicine 1. Cecile, Textbook of Medicine, current Edition 2. Harrison, Textbook of Medicine, Current Edition Obstetrics and Gynecology 1. William Obstetrics, 20th Edition Textbook of Obstetrics 2. Novak’s Gynecology, 12th Edition comprehensive Gynecology, 3rd Edition Pediatrics and Nutrition 1. Textbook of Pediatric by Waldo Nelson 2. Textbook of Pediatric and Child Health by by Fe del Mundo, Felix Estrada, Perla D. Santos-Ocampo, Xerxes Navarro 3. Red-Book Committee on Infectious Diseases, American Academy of Pediatrics, 24th Edition, George Peter-Editor Preventive Medicine 1. Foundations of Statistical Analysis for Health Sciences by Ophelia Mendoza, Maridel Borja, Caridad Ancheta. Ofelia Saniel. Jesus Sarol 2. Research Methods in Health and Medicine (Philippine Council for Health Research and Development), Department of Science and Technology, Volume I by F.S. Sanchez, S.I. Morelos, J.C. Baltazar 3. Reading in Preventive Medicine II (UST, Dept. of Preventive and Social Medicine) 4. Bioethics by A. Angles Tan-Alora, MD 5. The Implementing Rules And Regulations of the National Health and Insurance Act of 1995. 6. Epidemiology Manual by Dr. Rosa Santos-Carreon (UST) 7. Lectures and manuals on Preventive Medicine from different Philippine Medical Schools. You don’t have to read all these textbooks. Just pick one good textbook per subject. As a doctor, we think it’s reasonable to expect that you have read at least one textbook cover-to-cover during Med School. I think these textbooks would be sufficient for you to have a good score in the Med Boards if you have read them during med school: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.

Biochemistry – Harper’s Anatomy – Snell Microbiology – Jawetz Physiology - Guyton and Hall Legal Medicine – the 2 Solis Books Pathology – Robbins Pharmacology – Katzung Surgery – Schwartz Internal Medicine – Harrison’s Ob-Gyne – William’s Pediatrics – Nelson’s Prev Med – your school notes

We know it’s hard to study all these 12 subjects cover-to-cover, but you had 4 years to do it. It can be done. If you have read these textbooks cover-to-cover, you can read them again during internship. (This suggestion, is of course, for medical students reading this primer before their internship year) Then, during your review for the Med Boards, use them again. You will have a good chance of topping the board exam, and at the very least, you would have really learned a lot, definitely more than the average medical graduate who uses review books. B. Preparing for the Boards – During Internship Start preparing for the boards as early as your medical internship.

If you haven’t read your textbooks well during med school, you’ll have to read review books instead. Take note that there is no review book that is superior to a textbook. And in the Med Boards, you won’t be able to answer 100% of the questions using review books alone. After all, review books were created on the assumption that you have read the textbooks. That being said, some review books are better compared to others in terms of content and readability. However, this may vary from person to person. So choose your review books well – consult various people and browse through each one. Buy your review books early, and don’t join the rush when review time comes. You have better things to do than stress about getting a review book, like study for the Boards. Study the book that you would read on your review while your rotation is on the same subject. This would serve as your first reading for the Boards and also as a review for the final exams of your rotation. Here are the books that you should study during your internship: 1. 2. 3. 4. 5.

Surgery Rotation – Surgery ABSITE(American Board of Surgery In-Training Exam) Review Pediatrics Rotation – Kaplan Pediatrics and Blueprints Pediatrics Ob-Gyne Rotation – Baby William’s or OB Blueprints Internal Medicine Rotation –Kaplan Internal Medicine or HighYield Internal Medicine All other Rotations – USMLE 1st Aid Step 1 (for the basic sciences)

Learn from your teaching rounds and case conferences. There are a lot questions in the Boards whose answers have been discussed in the teaching rounds and case conferences. And finally, learn from your patients. You’ll be able to answer quite a few questions in the boards based on what you have experienced in the clinics. So be inquisitive, read on your cases and communicate with your patients. C. Preparing for the Boards – After Internship First things first – Create a Good Plan After passing internship, reward yourself for a short time – go to the beach, party hard, relax! After that, it’s time to think about the Med Boards. It’s time to formulate a PLAN. Spend a whole day for this, preferably a quiet place where you can contemplate with minimal distractions. Do all of the following and write your results: 1.

Set your goal – do you want to merely pass the exams or be one of the topnotchers? Set your goal, make your plans to reach this goal and execute the plan with die-hard determination. Topping the Boards is not impossible – you could have average grades in med school and still top the boards by studying earlier (start during internship) or longer (take the February Boards). If you make this your goal in your own board exams, don’t think you’re being too ambitious. Dream, plan and then execute.

2.

Analyze how you learn – be honest! Ask yourself the following questions and conduct your review in a manner most beneficial to you:  Do you learn better if you’re alone or with a study group?  Are you a “visual” person who can absorb more information by reading books or an “audio” person who can absorb information better if there is another person who lectures to you or verbally quizzes you?  Are you the type of person who gets better exam scores whenever you read voluminous material once, or do you get better scores if you read simpler books several times?  Do you study better if you’re in a noisy room full of gorgeous people (e.g. in Starbucks) or in a quiet library?  Can you retain more information if there’s music in the background, junk food in front of you, and bright lights in the room?  Are you, like some people, unable to concentrate and study at home? Do you find your home and your family roles just too distracting for this kind of intense, serious review?  Do you feel unprepared about the Boards, to the extent to which that you would prefer hearing lectures about the Board Topics again within the structure of a formal review?  What are the possible distractions during your review? Write them down along with your plans on how to respond to them.

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] 3.

Make your plans based on your goal and learning style. Create a schedule and stick to it – this consists of a daily routine and schedule of subjects to be studied.

A daily routine for the board exams depends on you and your learning style. Put whatever you think would help you pass the boards in your daily routine e.g. exercise, going to mass, yoga, answering samplex everyday. The rationale for a daily routine is to keep your body clock as regular and as predictable as possible so that you’ll be at your most attentive yet relaxed state during your review and the exam itself. After planning for your daily routine, make a schedule of subjects to study. The study schedule you have made, you’ll realize soon enough, will not always be achieved, as things have a way of not going according to plan and you would sometimes finish earlier or later than you have planned. Look at your schedule and make changes accordingly. There would really be days when you would get burned-out. Relax, watch a movie or sleep the whole day. Burn-out is expected, and you would really have to take a rest for awhile. But bounce back as soon as possible. Don’t forget the basics in studying -- eat well, sleep well and pray hard. Some tips regarding schedules: 1. Most of us will be following a schedule that we ourselves created for the first time. Create it well and be as specific as possible. (e.g. time for going to the restroom, time to fix hair, time to text family, etc.) 2. Post your schedule where you can see it everyday. (e.g. in your study table, in your bed, in your restroom, or in all of the above) 3. Your alarm clock and wrist watch will be your best friends. Make sure you have these two and use them very well. 4. Your roommates (if applicable) may help you stick to your sked or veer your away from it. Adjust accordingly. Choosing Your Study Material If you have read them before, and you want to increase your chances of topping the Med Boards, use your med textbooks. Med Textbooks are the “Gold Standard” for the Med Boards. They will always beat review books in terms of content. However, if you haven’t read them before and have plenty of internship make-up duties after May 1, you would have to read your review books. These review books are discussed in a separate section of this primer. Supplement your review books with sample exams. Answering Sample Exams Everyday One of the most difficult things to do is to convince medical graduates to answer sample exams daily. Most would rather read first rather than answer questions. But this is what we have done during our Med Boards and we really think it’s a better system. By answering sample exams everyday, you’ll be able to know which things are relevant and which particular facts you should focus on. It would also enhance your test-taking skills. Let us repeat that: test-taking skills. The Med Boards is not merely a campaign to read as much material as possible as many times as possible. While it’s useful to learn content, be aware that you won’t be reading textbooks or review books in the Med Boards, you’ll be answering multiple-choice questions. Just like taking free throws during practice, the more you do it, the better your performance when it’s “game-time.” Just have the correct attitude with regards to answering sample exams. Most students answer sample exams hoping that the questions and the actual answer will come out in the Med Boards. The chances of that happening are slim. When you answer exams, look at the other choices aside from the correct one. Discuss why they were included in the first place; find out why they are wrong. Then write why the correct choice is such. This ability to distinguish right choices from the wrong ones and to discuss why is the purpose of answering these sample exams. In the Med Boards, you will be doing precisely that– eliminating wrong choices before you arrive at the actual answer. What sample exams should you use? Ask your friends for it, those that came from med schools are usually the best. Remember to answer at least 100 sample exam questions everyday – 50 in the morning upon waking up while having breakfast and another 50 before you go to sleep. Dealing with your Family, Love Ones and Friends Communicate with your parents your fears and concerns about the Med Boards. Solicit their help and understanding no matter what the outcome might be and pledge that you’ll be giving your very best. For your significant other(s), =), tell them that you’ll need to focus on the Med Boards and that they need to understand that you have to spend less time with them and more time hitting the books for the next three months. For your friends, especially those whom you consider to be good influences, make these Med Boards your great adventure. Bunk in

together, conduct small-group discussions, emotionally support each other. Study together, have fun together and ultimately, be licensed physicians together. One important social commandment that that you should follow: Be kind to everyone. The Med Boards will bring out the best and the worst in people, which includes you, your parents, your love ones and your friends. Like what was said in the book “7 Habits of Highly Effective People” by Stephen Covey, “Seek first to understand, then to be understood.” So be the first to understand why people sometimes act crazy while you’re busy preparing for the Med Boards – and be kind to everyone! D. Preparing for the Boards – Exam Day Some people would take the Med Boards whether they feel prepared or not, but other people would like to assess their chances before they take the Med Boards (especially those who are taking it for the 3rd time). There’s no hard and fast rule that will tell you whether you’re ready to take the boards or not, but we think that these guide questions will help: 1. Did you have good grades during med school? If not then you definitely should have studied harder after your internship. If, after honest introspection, you haven’t studied that hard, and in fact have failed to finish some subjects, maybe you should open yourself up to the idea of studying longer in preparation for the next med boards. 2. Were you able to stick to your schedule (which has to be well planned) more than 90% of the time? 3. In the sample exams that you are answering now that the Med Boards are near are you getting scores at least 60/100 consistently in almost all subjects? 4. Are you physically and emotionally ready to take the Med Boards? Be honest in answering the questions above and use them as guide in making your decision. If you have decided to take the Med Boards, let us plan for the Big Day itself. First, make sure that at least two weeks before the exams, you have adjusted your body clock to fit the board exam sked – meaning you should stop taking siestas from 7am-4pm. A week before the exam, start sleeping as early as 9pm or 10pm You can also go to your testing site a day before the exam so that you’ll know whether you should bring a mini-fan or a jacket during your Boards (depends on the temperature of your room). You are required to take the exams in your school uniform although in our experience this isn’t strictly enforced. The night before the exam, prepare to bring the following PRCmandated materials: 1. Notice of Admission 2. PRC Official Receipt 3. Application Stub 4. PRC Official Receipt 5. Black Ballpen 6. Two Mongol Pencils No.2 7. One Long Brown Envelope 8. One Metered-Stamp Window Envelope 9. One Long Transparent (clear) Plastic Envelope It’s also useful to bring the following on you exam day: 10. Water 11. Baon (sandwiches, fruits, etc.) 12. Certain meds – painkillers, antidiarrheal meds, etc. Stop studying and make sure you’re in bed by 9pm the night before your exams. Remember that you have to wake up very early the next morning with Biochemistry as your first subject. Come to your site around 6:30AM. Make sure that you are never late for the exams! Do some last-minute pep talks with your friends and classmates. You have one hour breaks between subjects. You can eat during these breaks - separate rooms are provided. Attend to your restroom needs since you won’t be able to go out of the room once the exam starts. While taking the exams, maintain your focus and never panic. E. Preparing for the Results of the Med Boards First things first, prepare for any eventuality. Don’t ignore the various possibilities regarding the results of you Med Boards. The more you bring these emotions out into the surface, the better it is for you and your loved ones.

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] Reflect on this long before your Med Boards: what will I do and how would I react in these situations: A.) I top the Med Boards B.) I passed the Med Boards C.) I failed the Med Boards. Prepare your parents, love ones and friends for the best and the worst. Some tips: if you pass, pay it forward and help other people. If you fail, don’t do anything stupid like hurting yourself – assess what you still need to do, keep your chin up and know that you will be a doctor, it will just take a little longer. Have faith in Him, and have faith in yourself. Be informed that the results are released 2-3 days after the last day of the exams. People text or call those who have passed immediately. You can tune in to the radio or view the following websites to confirm: Inquirer, BomboRaydo, PRC website, etc. to confirm. For those who have flunked the exams, your grades are mailed to you as soon as possible. For those who have passed, your grades are mailed to you 1-2 months after. The oathtaking is set 2-4 weeks after the last day of exams and is usually held at the PICC. The Philippine Medical Association sets up a booth there so you can apply as a member. Your PRC card is given immediately after the ceremonies; however, it’s advisable to just get them a week after to avoid the stampede. III. OUR PERSONAL RECOMMENDATIONS A. Review Books DISCLAIMER: At best, only 40-50% of the answers in the exams can be found in any review book. Also, please be advised that textbooks will always be superior to review books in terms of content, and sometimes in terms of readability. But reading them is still better than reading your textbooks if you haven’t read these textbooks before or if you’re pressed for time. Other sources of information are transcriptions (you won’t know which topics you should focus on), sample exams (not enough by themselves), or stock knowledge (its suicide if you rely on these for the Boards). The review books were analyzed according to content (must provide high-yield material) and readability (there’s no use reading highyield material if the writing is so complex that you cannot retain the information). We have made my recommendations based on these criteria, taking into consideration the medical graduate with average grades in med school. However, you may have your own learning style, and the other review books may work better for you. Some people are obsessivecompulsive and want to read the most comprehensive review books. Others would prefer shorter books that they could really master. Read the analysis of each book and decide whether that book is for you. Browse through the different books, get a feel for their content and readability and choose them well. I. Basic Sciences A. Anatomy 1. Snell’s Clinical Anatomy Review (7-10 days) – very comprehensive. But lacking in terms of readability. However if you are able to read this review book and supplement it with sample exams and Hi-Yield anatomy, this would give you a good foundation of anatomy and a very good chance of passing the Med Boards. 2. UPEC, UERM, Fatima Anatomy Review Questions (2-3 days) – compilation of previous board exam questions on anatomy. Very useful, since it would give you ideas on what you should focus on in your review. And remember that anatomy never changes, (ever heard of a new organ discovered recently?) thus, examiners could only ask so much questions. That’s why reading previous questions would work for anatomy. You can buy original version at their center. 3. Hi-Yield Gross Anatomy (2-3 days) – some hard-core toxic students think it’s too superficial, but this book really contains must-know clinical facts about anatomy. It’s also very easy to read and retain. 4. First Aid Anatomy (½ day) – easy to read and high-yield, but not enough material. 5. Clinical Anatomy Made Ridiculously Simple (3-5 days) – as easy to read as your newspaper comics. However, the problem with this book is that it's systems-based, (cardiovascular, skeletal, renal, etc) and not region-based. And it's not that fun to read as Micro MRS. BRS Gross Anatomy (2 weeks minimum) – comprehensive 6. but Snell is better. Little illustrations and clinical correlation. 7. Hi-Yield Histology, Hi-Yield Neuroanatomy, Hi-Yield Embryology (10-14 days) – there are only about 10 questions in the Boards about these topics, and the two weeks that you would spend to study them is simply not worth it. Just read about these topics from UPEC Anatomy. Recommendations: Read Snell Anatomy Reviewer ALONG with Netter Atlas. Supplement with Hi-Yield Anatomy (use the latest edition; the first few editions are not as good) Use Sample Exams to point out how they ask questions in this subject.

B. Physiology 1. Ganong Physiology – good content but not very readable. If you read this from cover to cover, you will definitely know more than the average medical graduate. 2. BRS Physiology (2-3 days) – concise, easy to read and highyield. One of the most useful books for the Boards. 3. First Aid Physiology (1 day) – similar to BRS Physiology, it emphasizes important physiologic concepts. 4. Special Topics in Guyton’s Textbook of Medical Physiology - Read chapters on sport/exercise, space, high altitude, diving, aging, temperature and sleep physiology. These topics are not found on the other review books. Recommendations: BRS Physiology + Special Topics in Guyton and Hall. C. Biochemistry 1. Digging-Up the Bones Biochemistry (1 day) –The “comics” of biochemistry. Contains must-know facts about biochemistry in just 110 easy-to-read pages. Would give you a good outline of biochemistry. 2. First Aid Biochemistry (1 day) – contains very useful diagrams and mnemonics. Cannot stand on its own, but it is a good supplement to the other books. 3. Kaplan Biochemistry (7-9 days) – very good discussion on molecular biology, DNA and clinical correlations. These topics are more frequently tested now than metabolism thus this book is better than Lippincott. And it takes almost the same amount of time to read. If you have poor background on biochemistry during med school, this book is for you. 4. Lippincott Biochemistry (5-7 days) – comprehensive but easy to read. Focuses on metabolism. 5. Hi-Yield Biochemistry (1-2 days) – short, but hard to retain since important points are not emphasized. Competes with Digging-Up the Bones which is actually better. Recommendations: Lippincott Biochemistry + DNA, Genetics Chapters in Kaplan Biochemistry D. Microbiology 1. Microbiology Made Ridiculously Simple (4-5 days) - one of the best review books ever made. Makes microbiology fun and easy to read. And it’s comprehensive too. Read the chapter on antibiotics – it would help you in pharmacology. The end-ofchapter tables are really useful especially as a last-minute review. 2. First Aid Microbiology (1-2 days) - complements MMRS. Summarizes important points. 3. Philippine Textbook of Parasitology by Dr.Belizario (3-5 days) – if you have the time, this book will cover just about anything they can ask about parasitology. Just browse though it and write short notes about each disease with focus on life cycles of malaria and dengue. Recommendations: Microbio MRS + USMLE First Aid Microbio + notes on parasitology. E. Pathology 1. Baby Robbins (3-4 days) – easy to read but very long 2. First Aid Pathology (2-3 days) – In about 70 pages, mustknow topics in pathology are presented in easy-to-absorb format with tons of useful mnemonics. 3. Pathology BRS (3-4 days) - write down notes regarding the first few chapters of the book and put these on your 1st Aid book. The rest of the book is also useful and you should read them, but only so that you could put some more notes on your 1st Aid book. Recommendations: Baby Robbins OR Patho BRS + USMLE First Aid Patho F. Pharmacology 1. Katzung’s Pharma Review (1-2 weeks) – a thick book, but chapters are short and easy enough to understand. Excellent diagrams. If you want to excel in pharmacology, read this. 2. Pharmacology Companion (4-5 days) - This is a book made by students for students, like 1st aid. Complex information is seamlessly synthesized in very simple tables. Get a copy from Fatimah and FEU graduates. 3. First Aid Pharmacology (1-2 days) - makes certain topics in pharmacology clearer and easier to absorb. Easy to read and full of must-know facts. Not as comprehensive as Katzung’s. 4. Pharmacology Recall (3-4 days) - The question and answer makes relevant, must-know topics easy to absorb. Not as comprehensive as Katzung’s. 5. Lippincott Pharmacology (5-7 days) – just a little shorter than Katzung’s but harder to absorb. Recommendations: Katzung Pharma Review

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TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] II. Clinical Sciences A. Internal Medicine 1. Hi-Yield Internal Medicine (2-3 days) – concise, easy to read and contains must-know information that you haven’t realized before. Not as comprehensive as NMS. 2. Blue Prints Medicine (3-4 days) – easy reading but contains material that you probably already know. 3. NMS Medicine (6-7 days) – the book for the obsessivecompulsive. Comprehensive. However, not as easy to read as the above IM books. You would probably forget the information it contains as time goes by since important points were not emphasized. Recommendations: The internal medicine exam is multidisciplinary – questions are about subjects such as physiology, pharmacology, microbiology and pathology. No single book would suffice to give you a good preparation for IM. It is recommended that you master one of the 3 books mentioned and stick with it. There is NO need to read about treatment protocols, memorize dosages or know topics such as ECG, CXR interpretation, metabolic derangements or common formulas. B. Pediatrics 1. Kaplan Pediatrics – good discussion on general principles of pediatrics. 2. Peabrain Pediatrics (1 day) – very short. Inadequate yet it provides good information about congenital heart diseases and common illnesses such as dengue and tetanus. 3. Baby Nelson’s (4-5 days) – Easy reading but would take some time to read. Also, if you look closely, most of information found here is a little bit superficial. 4. Blueprints Pediatrics (3-4 days) – incomplete but easy to learn. Most reviewees turn to this book for pediatrics. 5. NMS Pediatrics (4-5 days) – the most comprehensive. For the obsessive-compulsive. However, the problem with this book is similar to Snell’s – you would probably forget the material by the time you do your second reading. There’s just too much information and important points are not emphasized. Recommendations: Kaplan Pediatrics C. Surgery 1. Surgery Absite Review – superior to surgery recall in an easy to understand format; however still insufficient for the Med Boards. 2. Advanced Surgery Recall (4-5 days) – Remember: get the Advanced version which is for residents. Delightful to read and easy to recall. Contains hi-yield topics not only for surgery but also for anatomy, physiology, microbiology, pharmacology, internal medicine and pediatrics. You must read this. 3. Rush Surgery (10-14 days) – very comprehensive and if you’re the obsessive-compulsive type, this is probably the most high-yield for surgery. However, it would eat up a lot of your time for the other subjects, and it may actually be overkill for surgery. 4. NMS Surgery (6-7 days) – as toxic as IM NMS. Thorough but not high-yield. Read Rush Surgery rather than this book if you’re the obsessive-compulsive type. 5. BRS Surgical Specialties (2-3 days) – a good book for the different surgical subspecialties (Orthopedics, Ophthalmology, ENT, etc.) but Surgery Recall is more than adequate. 6. Blueprints Surgery (3-4 days) – easy to read but incomplete. Recommendations: Surgery Absite Review + Prayers =) D. Obstetrics and Gynecology 1. Blueprints Obstetrics and Gynecology (2-3 days) – easy to read and contains all you need to know for the exam. 2. NMS Obstetrics and Gynecology (5-6 days) – a little bit more comprehensive compared to Blueprints or BRS. The best in the NMS series. Still easy to read. 3. BRS Obstetrics and Gynecology (3-4 days) – similar to Blueprints – easy to read and contains must-know facts. 4. Baby William’s (6-7 days) – the most comprehensive. However, it’s just too long. And it only has information for obstetrics, not gynecology. Recommendations: Blueprints OB-Gyne + STD Treatment Guidelines + Primer on Different Gyne Cancers released by POGS (ask your residents about it) E. Legal Medicine, Ethics and Medical Jurisprudence 1. UPEC, Fatima, UERM Legal Medicine, Ethics and Medical Jurisprudence Review Questions (1-2 days) - Since none of the Members of the Board Examiners are lawyers, they frequently lift questions from previous legal med exams and from Solis. One of the easier subjects for the Boards. Read and correct questions from this reviewer and you’ll do great.

2.

3.

Legal Med and Med Juris Summary (1-2 days) – complement UPEC Legal Med with this book. Don’t try to read its baby version called Legal Med and Med Juris Notes. Solis’s Medical Jurisprudence and Solis’ Legal Medicine (12 weeks) – You would get a high score in Legal Med subject of Boards if you’ve mastered these two books since all questions in Legal made are based on them. If you’re obsessivecompulsive, read them. Otherwise, it’s overkill.

Recommendations: Legal Med and Juris Summary + Sample Exams F. Preventive Medicine 1. Pre-Test Prev Med (1-2 days) – can help but quite difficult to procure 2. UPEC Preventive Medicine Questions (1-2 days) – You have to read this for the Prev Med exam – this would give you a fighting chance in the Boards. 3. UE Notes/MCU Notes/UST Notes (1-2 days) - complement UPEC with these books. UST Notes is the best, try to get a copy if you can. 4. Dr.Banzuela’s PhilHealth Primer for the Med Boards (2 hours) – social insurance was tested in the past board exams. This is the best source about PhilHealth – it’s high-yield and easy to read. Email the author at [email protected] for a free copy. 5. Hi-Yield Biostatistics (1/2 day) – helpful in understanding biostatics, but a little difficult to understand. Recommendations: Notes during Med School + Pre-Test Prev Med + Sample Exams B. Suggested Routine Schedule Time 5:00 AM – 6:00 AM 6:00AM-6:30am 6:30am-7:00am 7:00am-7:30am 7:30am-8:00am 8:00am-12:00pm 12:00pm-1:00pm 1:00pm-5:00pm 5:00PM-6:30PM 6:30pm-7:00pm 7:00pm-8:00 pm 8:00pm-10:00 pm 10:00pm-11:00pm 11:00pm-5:00am

Activity Answer 50-item sample exams; plan for the day Wake-up and exercise (e.g. walk to La Mesa EcoPark) Bath Breakfast Prepare for Materials for Studying Read Review Book for Current Subject Lunch Read Review Book for Current Subject Relaxation - basketball, DVD watching, texting time Bath Dinner Read Review Book for Current Subject Answer 50-item sample exams; plan for the day Sleep

For Your Monthly Schedule: 1. We recommend at least 3 readings for your Basic Sciences Subjects and 2 readings for your Clinical Sciences subjects 2. It’s ok to allocate more time to the more difficult subjects like Anatomy and Surgery but don’t spend so much time on these subjects to the point that are not able to prepare well for the relatively easier subjects such as Legal Med and Internal Med. 3. Study Physiology first before the other subjects – it will serve as a good background for the other subjects. C. Maintaining Attitude and Focus Several Tips on Maintaining Attitude and Focus: 1. Before your review, try to watch “The Secret” or read “The 7 Habits of Highly Effective People.” 2. Live according to your sked. Let it guide your activities for the next three months. 3. If you get burned out, watch a movie or go on a food trip with friend. But try to compensate for lost time. 4. Stop texting too much or watching TV too much. Set aside a fixed amount of time per day for these activities. 5. Talk to your family, love ones and friends about your current emotional state. 6. Keep yourself fit. Walk around every morning. Play basketball or badminton in the afternoon. 7. Pray.

IV. FREQUENTLY-ASKED QUESTIONS

1.

If I registered for the Med Boards but absent during the exam itself, would it be counted as a “FAIL” ANSWER: No, you’ll just be marked as absent. It won’t be credited as an attempt. However, if you were present in at least

TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 Page 8 of 9 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected]

TOPNOTCH BOARD PREP PRIMER TO THE PHILIPPINE PHYSICIAN LICENSURE EXAMINATIONS VERSION 2010 For inquiries visit www.topnotchboardprep.com.ph or email us at [email protected] one day, and absent in some other day, it would be reported as an automatic fail. 2.

3.

Can I top the med boards despite not having high grades in med school? ANSWER: Yes, but you’ll need to work harder and longer for it. Some individuals have done it by taking the USMLE first, and then they reviewed for another six months for the Med Boards. But usually, those who have topped the med boards are consistent good performers even in med school – they’ve studied hard and used textbooks instead of review books. Can I send someone to register for me? ANSWER: You need to register personally for the med boards.

4.

If my average score is 74.99%, may I ask PRC for a recount? ANSWER: A few years ago, this was possible. lately, we’ve heard that they don’t allow recounts anymore. However, there’s nothing to lose if you’ll try.

5.

Can I take the Boards even as a med student? ANSWER: Surprisingly, yes, but only for four subjects and only after you have passed 2nd year. Since you still have to take some exams after internship, most people opt to take all 12 exams after they have graduated.

clinical rotations. He had done all these as a working student, supporting himself financially throughout Med School. Currently, Dr.Varilla is a lecturer in Pharmacology for the Med Boards. Authors’ Note The authors have attempted to make the contents of this primer as accurate and as up-to-date as possible. However, it is possible that the PRC or Board of Medicine have changed certain policies since this writing. The authors will gladly make corrections as these errors are brought to their attention, and you are highly encouraged to get in touch with them for these amendments. Thank you! Dedication For God, our Country, Our Family and Our Friends…For you! May this primer inform you, help you, and inspire you…

V. FINAL ADVICE Those who have taken the exam know that the Boards is neither a good indicator of the medical knowledge one possesses nor will it predict whether or not one would be a competent, ethical and caring physician. Thus, those of us who have taken the exams never look down upon those who have flunked it. However, the problem is that the public (which includes our relatives, friends and lower classmen) mistakenly think otherwise – thus there is so much pressure to pass on your very first try. In reality, one can flunk the exam even if one has good grades during med school and adequate preparation during the review. More than a test of your knowledge, the Med Boards is a test of your character. The best tip we can give you is this: in the end, it doesn’t really matter what particular review books you have read; motivation, dedicated study, discipline, concentration and faith in God – these are actually what you need to pass the Boards. Give your best, study harder than ever before and always think positive thoughts. Good luck to you, descendants of Hippocrates, and may you pass the Philippine Physician Licensure Examinations! From Your Friends, Enrico Paolo C. Banzuela, MD Vincent M. Varilla, MD About the Authors Dr. Enrico Paolo Chiong Banzuela is part of Ateneo de Manila High School, Class 1998. He graduated from the University of the Philippines College of Medicine, Class 2005, Intarmed Program. He is a Clinical Instructor at San Beda College of Medicine teaching biochemistry and physiology. To improve his teaching skills, he is taking up his Master’s in Health Professions Education at the University of the PhilippinesNational Teachers Training Center. When he was starting his career, he was also a University Researcher under the PhilHealth Research Study Group, UP Manila - National Institutes of Health. He co-authored a book entitled “Survival Guide for Doctors, and Non-Doctors Too” with Dr.Willie Ong. A seasoned and excellent reviewer for the Med Boards, teaching Physiology, Biochemistry, Microbiology, Pathology, Dr.Banzuela created this primer to help as many medical graduates as possible pass the most difficult exam of their lives – the Med Boards. Writing the current version of the primer with him is Dr.Vincent Maranan Varilla. Dr. Varilla graduated salutatorian of Philippine Science High School in 1997. He was then accepted as an Oblation Scholar of UP under its INTARMED program. After much thought, he decided against taking up Medicine and chose to take up Management Engineering in the Ateneo de Manila University instead. He graduated cum laude with a double degree in Economics-Honors, and took a short diplome course in International Relations from the Institut d’Etudes Politiques de Paris (Sciences Po) in Paris, France, graduating with High Distinction. He was active in student organizations throughout college, and became president of the Ateneo HPAIR (Harvard Project for Asian and International Relations) Union during his senior year. He then worked for three years with Unilever Philippines. He had just received a recent promotion, and was also accepted for a fellowship in International Political Economy in New York, when he decided to finally fulfill his destiny and become a doctor. He was accepted at the University of the Philippines College of Medicine in 2004 and graduated in May of 2009. Along the way, he managed to present a research paper in the Netherlands, take a clerkship elective in the United States, become president of a medical fraternity, and was awarded as an outstanding clerk/intern in several

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